NR547 Week 5 Exam V3 | NR547
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 5 Exam) | Chamberlain University
1. A 9-year-old male presents with persistent irritability and severe temper outbursts
occurring four times per week. The parents report this has been happening for over a year
across multiple settings. Which diagnosis is most appropriate?
A. Disruptive Mood Dysregulation Disorder
B. Oppositional Defiant Disorder
C. Bipolar I Disorder
D. Conduct Disorder
Answer: A
Rationale: Disruptive Mood Dysregulation Disorder (DMDD) is characterized by chronic,
severe persistent irritability and frequent temper outbursts. The DSM-5 requires these
symptoms to be present for at least 12 months and occur in at least two settings. This
diagnosis was specifically created to reduce the over-diagnosis of pediatric Bipolar
Disorder.
,2. When differentiating between Dementia and Depression in an elderly patient, which
finding is more characteristic of Depression (Pseudodementia)?
A. Patient makes little effort to answer questions
B. Sundowning behavior
C. Patient tries to hide cognitive deficits
D. Slow onset of symptoms
Answer: A
Rationale: In cases of pseudodementia associated with depression, patients often exhibit a
‘don’t know’ attitude and make little effort to perform tasks. This contrasts with true
dementia, where patients often struggle to perform and attempt to compensate for or hide
their deficits. Cognitive testing in depressed patients often shows inconsistent results that
improve with encouragement.
3. A patient reports a sudden onset of neurological symptoms, including blindness and
paralysis, shortly after a traumatic car accident. Extensive medical evaluation reveals no
physiological cause. What is the most likely diagnosis?
A. Conversion Disorder
B. Illness Anxiety Disorder
C. Somatic Symptom Disorder
D. Factitious Disorder
,Answer: A
Rationale: Conversion Disorder, also known as Functional Neurological Symptom
Disorder, involves unexplained physical manifestations of a neurological nature. These
symptoms are not intentionally produced and usually follow a stressful or traumatic event.
The PMHNP must ensure that clinical findings provide evidence of incompatibility between
the symptom and recognized neurological or medical conditions.
4. Which clinical feature is essential for a diagnosis of Bipolar II Disorder?
A. At least one hypomanic episode and one major depressive episode
B. At least one manic episode
C. Psychotic features during a hypomanic episode
D. Hospitalization during a hypomanic episode
Answer: A
Rationale: Bipolar II Disorder requires the occurrence of at least one hypomanic episode
and at least one major depressive episode. Importantly, there must have never been a full
manic episode. If psychosis or hospitalization occurs during the elevated mood period, the
episode is classified as manic, leading to a Bipolar I diagnosis.
5. A 25-year-old female reports intense fears of abandonment, unstable interpersonal
relationships, and frequent feelings of emptiness. She also describes episodes of self-harm
when feeling rejected. Which Cluster B personality disorder is most likely?
A. Histrionic Personality Disorder
, B. Borderline Personality Disorder
C. Antisocial Personality Disorder
D. Narcissistic Personality Disorder
Answer: B
Rationale: Borderline Personality Disorder is characterized by a pervasive pattern of
instability in interpersonal relationships, self-image, and affects, along with marked
impulsivity. Key features include frantic efforts to avoid real or imagined abandonment and
recurrent suicidal behavior or self-mutilation. The PMHNP must utilize dialectical behavior
therapy as a primary evidence-based treatment for this population.
6. A patient presents with a BMI of 16.5, an intense fear of gaining weight, and a distorted
body image. Despite being underweight, the patient restricts food intake significantly. What
is the primary diagnosis?
A. Anorexia Nervosa
B. Bulimia Nervosa
C. Binge Eating Disorder
D. Avoidant/Restrictive Food Intake Disorder
Answer: A
Rationale: Anorexia Nervosa is defined by the restriction of energy intake leading to a
significantly low body weight, intense fear of weight gain, and disturbance in the way one’s
Differential Diagnosis in Psychiatric-
Mental Health across the Lifespan
Practicum | Q&A with Rationale (NR547
Week 5 Exam) | Chamberlain University
1. A 9-year-old male presents with persistent irritability and severe temper outbursts
occurring four times per week. The parents report this has been happening for over a year
across multiple settings. Which diagnosis is most appropriate?
A. Disruptive Mood Dysregulation Disorder
B. Oppositional Defiant Disorder
C. Bipolar I Disorder
D. Conduct Disorder
Answer: A
Rationale: Disruptive Mood Dysregulation Disorder (DMDD) is characterized by chronic,
severe persistent irritability and frequent temper outbursts. The DSM-5 requires these
symptoms to be present for at least 12 months and occur in at least two settings. This
diagnosis was specifically created to reduce the over-diagnosis of pediatric Bipolar
Disorder.
,2. When differentiating between Dementia and Depression in an elderly patient, which
finding is more characteristic of Depression (Pseudodementia)?
A. Patient makes little effort to answer questions
B. Sundowning behavior
C. Patient tries to hide cognitive deficits
D. Slow onset of symptoms
Answer: A
Rationale: In cases of pseudodementia associated with depression, patients often exhibit a
‘don’t know’ attitude and make little effort to perform tasks. This contrasts with true
dementia, where patients often struggle to perform and attempt to compensate for or hide
their deficits. Cognitive testing in depressed patients often shows inconsistent results that
improve with encouragement.
3. A patient reports a sudden onset of neurological symptoms, including blindness and
paralysis, shortly after a traumatic car accident. Extensive medical evaluation reveals no
physiological cause. What is the most likely diagnosis?
A. Conversion Disorder
B. Illness Anxiety Disorder
C. Somatic Symptom Disorder
D. Factitious Disorder
,Answer: A
Rationale: Conversion Disorder, also known as Functional Neurological Symptom
Disorder, involves unexplained physical manifestations of a neurological nature. These
symptoms are not intentionally produced and usually follow a stressful or traumatic event.
The PMHNP must ensure that clinical findings provide evidence of incompatibility between
the symptom and recognized neurological or medical conditions.
4. Which clinical feature is essential for a diagnosis of Bipolar II Disorder?
A. At least one hypomanic episode and one major depressive episode
B. At least one manic episode
C. Psychotic features during a hypomanic episode
D. Hospitalization during a hypomanic episode
Answer: A
Rationale: Bipolar II Disorder requires the occurrence of at least one hypomanic episode
and at least one major depressive episode. Importantly, there must have never been a full
manic episode. If psychosis or hospitalization occurs during the elevated mood period, the
episode is classified as manic, leading to a Bipolar I diagnosis.
5. A 25-year-old female reports intense fears of abandonment, unstable interpersonal
relationships, and frequent feelings of emptiness. She also describes episodes of self-harm
when feeling rejected. Which Cluster B personality disorder is most likely?
A. Histrionic Personality Disorder
, B. Borderline Personality Disorder
C. Antisocial Personality Disorder
D. Narcissistic Personality Disorder
Answer: B
Rationale: Borderline Personality Disorder is characterized by a pervasive pattern of
instability in interpersonal relationships, self-image, and affects, along with marked
impulsivity. Key features include frantic efforts to avoid real or imagined abandonment and
recurrent suicidal behavior or self-mutilation. The PMHNP must utilize dialectical behavior
therapy as a primary evidence-based treatment for this population.
6. A patient presents with a BMI of 16.5, an intense fear of gaining weight, and a distorted
body image. Despite being underweight, the patient restricts food intake significantly. What
is the primary diagnosis?
A. Anorexia Nervosa
B. Bulimia Nervosa
C. Binge Eating Disorder
D. Avoidant/Restrictive Food Intake Disorder
Answer: A
Rationale: Anorexia Nervosa is defined by the restriction of energy intake leading to a
significantly low body weight, intense fear of weight gain, and disturbance in the way one’s
